Tuesday, February 28, 2006

Medical Malpractice crisis has ended.

Kevin Drum reports on a study that shows that in 2005 medical malpractice premiums increases only 2% in the first six months and increased not at all in the second half of 2005.

The study he references also explains that in the last three decades, medical malpractice premiums have increased sharply along with all other property insurance premiums when investment income to insurance companies dropped sharply, and then did not increase when investment income was high. There is no correlation to some fictional increase in medical malpractice legal judgements, and caps on such judgements have not correlated to decreases in medical malpractice insurance premiums.

Why am I not surprised? Laws thgat put caps on medical malpractice judgements are nothing more than another Republican scheme to redistrubute money from injured people to the insurance companies who lobby Congress and make large contributions to mostly Republicans.

Monday, February 27, 2006

Healthcare expenses to reach 20% of GDP in 10 years

Estimates of healthcare expenses expected to reach one dollar in every five spent in the U.S. within ten years.
The projections estimate that collective public and private spending for health care will average about $12,320 per person in 2015, compared with $6,683 per person in 2005.
See Knight Ridder.

Sunday, February 26, 2006

Why should healthcare be linked to employment?

This is an ancient debate (year 2000) on whether the US should adopt universal health care by Adam Gopnik and Malcolm Gladwell. Gladwell was opposed to universal healthcare then. Now he has changed his mind, partly because of the thoughts he published in This article.

Here is what Gladwell recently wrote on the subject:
the idea of employer-based health care is just plain stupid--and only our familiarity with it and sheer inertia prevent us from rising up in rebellion. I always try to think of a suitable analogy and fail. The closest I can come is to imagine if we had employer-based subways in New York. You could ride the subway if you had a job. But if you lost your job, you would either have to walk or pay a prohibitively expensive subway surcharge. Of course, if you lost your job you would need the subway more than ever, because you couldn't afford taxis and you would need to travel around looking for work. Right? In any case, what logical connection is there between employment and transporation [sic]? If you can answer that question, you can solve the riddle of the U.S. health care system.
That really is the question, isn't it?

How does tying healthcare to employment make the economy more efficient? Ask General Motors, Ford, and (Yes) Wal-Mart. If we want employers to hire the most effective and efficient employees, then the employers should focus on what value each of those employees can add to the products or services offered for sale. With healthcare for those employees added to the cost of hiring each employee, then we are requiring employers to screen out those potential employees who, with their families, might cost a lot in healthcare expenses. That means the employer must employ less efficient employees if the healthcare costs of the most effective employee is above average.

A universal healthcare system takes that cost of healthcare off the employer and allows him to hire the most effective and productive employees. It also removes to cost of screening for health problems from the employer.

A universal healthcare system also removes the cost of determining eligibility for various health benefits from the entire system of providing healthcare. This cost is estimated at about a quarter of all healthcare expenses. It does so by spreading the costs of healthcare for each individual across the entire group of all people and eliminating the requirement that small groups who are separately insured must eliminate the most likely to be ill from their group.

A universal healthcare system also allows for lower administrative costs by providing for a single administrative system. The reduction in training costs is significant.

There is nothing that individual health insurers can offer by screening for the most healthy beneficiaries that can possibly offset these savings.

[Source Kevin Drum.]

Thursday, February 09, 2006

Bush to try stealth Social Security reform

Kevin Drum reports (from Allan Sloan) that the Social Security reform [That is, phase out of Social Security] is built into the administration's proposed budget.

Last year he announced it with great fanfare and delight in the State of the Union speech. Then he got his head handed to him. This year he is hoping no one will notice it in the proposed budget and sort of "accidently" pass it. What is the matter with these idiots?

This has little chance of passing, but bears a great deal of watching and close monitoring of the actions of our Congressional Representatives.

[Cross-posted to Politics Plus Stuff.]

Friday, February 03, 2006

An incomplete discussion of HSA's

Who benefits from HSA's? TPM Cafe has a discussion that covers some parts of it.

One problem I don't see discussed is how we get our health care. I have a single physician who I go to first for all illnesses and health issues. He has my records and my healthy history, something no other physician will have. My memory isn't perfect, and in some cases I flat don't know what problems I had. For example, there is one medication my records tell me I am allergic to. I don't recall ever taking it and don't know what it was for.

I also get almost all my medications from a single pharmacist. He has the records of what I am taking, and a program that watches for drug interactions. I recently changed to a stronger version of one medication, and was warned by the pharmacist that it would be dangerous to continue taking the older prescription along with the newer one.

So What?

So I don't shop for price. The risk involved in getting medical services from a different provider with less information is higher than any price savings justifies. An HSA can only save money if I shop for price. I rank my priorities as health first, safety second and a long, long way further down is price.

Frankly, HSA's seem to me to be an effort to prove that all production and distribution of goods and services can be optimized by manipulating the money incentives. That implicitly assumes that I would prefer to be wealthier than I would to be healthier.

Unfortunately for those assumptions, health care is more of a human problem than an economic one. Efforts to apply nothing but economic incentives to the production and delivery of health care will fail some serious tests. Economics are a restriction on health care, but they to not optimize its production and delivery. Health care is too important to basic humanity to treat as nothing more than a simple set of commercial exchanges.

Thursday, February 02, 2006

Want reasonable healthcare for all Americans?

You can't beat Ted Kennedy's current proposal.

This proposal will provide quality affordable health care for all Americans. It will also take the burden of providing health care off of American employers, while allowing those which wish to provide greater benefits to employees the right to do so.

Bush disagrees.
as he attempted to do last year with his Social Security privatization fiasco, President Bush will try to make the American people believe that the solution to rising health costs is to shift more and more of those costs to ordinary Americans, or to deny care to those in need.
The fact is, health care is the provision of health services in a manner that is not directly related to individual productivity, but which is directly related to keeping workers productive.

Employers should not be directly responsible for health costs outside of those related to workman's compenstation which pays for health costs directly caused by conditions of the workplace. Employers shouold not directly be required to pay for the costs of such things as birth defects. Families need to cover those, but they need insurance that covers it. Their employers should NOT be required to cover that kind of insurance. Society in general should. This is a social cost, not an employment cost.

Kennedies proposal comes a lot closer to applying the costs appropriately than the current structure of insurance does, and it makes American employers a lot more competitive internationally than does the current employer-laden structure.